Simple Job Application Form

Plates on the Square Job Application

Please complete the form below to apply for a position with us.
Full Name *

First Name Middle Name Last Name
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Email Address *
Home Number

Area Code Phone Number
Cell Number *

Area Code Phone Number
Applying for Position

Host Wait Bartender Barback Cook Dishwasher Security
Start date *

Month Day Year
Hours Available to Work
(Please indicate times beside each applicable day)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Have you ever been convicted of a felony? *

Yes No
If Yes, Please Explain
Are you a U.S. Citizen? *

Yes No
If not a U.S. citizen, are you authorized to work in the U.S.?

Yes No
Previous Employment
Current or Most Recent Employer
Name of Employer
Complete Address
Name of Supervisor
Phone Number

Area Code Phone Number
Dates of Employment
Job Title
Reason for Leaving
Be Specific
Describe your responsibilities as well as any special skills used or learned, advancements, promotions:
May we contact your employer?

Yes No
Second Most Recent Employer
Name of Employer
Complete Address
Name of Supervisor
Phone Number

Area Code Phone Number
Dates of Employment
Job Title
Reason for Leaving
Be Specific
Describe your responsibilities as well as any special skills used or learned, advancements, promotions:
May we contact your employer?

Yes No
Other Relevant Employer
Name of Employer
Complete Address
Name of Supervisor
Phone Number

Area Code Phone Number
Dates of Employment
Job Title
Reason for Leaving
Be Specific
Describe your responsibilities as well as any special skills used or learned, advancements, promotions:
May we contact your employer?

Yes No
References

(List 2 other than relatives and employers listed above)
Reference #1
Name

First Name Last Name
Relationship
Company
Position
Phone Number

Area Code Phone Number
Reference #2
Name

First Name Last Name
Relationship
Company
Position
Phone Number

Area Code Phone Number
Why do you want to work in this industry and particularly at Plates & Uncorked?
What is your favorite restaurant and what is your favorite dish there?
What is your strongest asset for the job and why should we hire you over another strong candidate?
Is there anything else you would like for us to know about you?
By clicking the submit button below and/or submitting a printed copy of this application, I certify that the facts and information contained in this application are true and complete to the best of my knowledge and understand that, if hired, falsified statements shall be grounds for dismissal. I authorize investigation of all statements contained herein, and the references and employers listed above to give any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release Plates, Inc., from all liability for any damage that may result from utilization of such information. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act and other relevant federal and state laws.
Should be Empty:

Plates on the Square Job Application

References